MALAVIKA PRASANNA DDS - Dentist License in Illinois | # 019028441

MALAVIKA PRASANNA DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028441

License Status

NOT RENEWED

Business

N

First Name

MALAVIKA

Last Name

PRASANNA DDS

Business Name

MALAVIKA PRASANNA DDS

Original Issue Date

07/20/2010

Effective Date

09/12/2012

Expiration Date

09/30/2015

State

IL

Ever Disciplined

N

LastModifiedDate

02/08/2016